The number of digital medicine technologies, a category of tools that use software and algorithmically driven products to measure or intervene to improve human health, [1] has expanded enormously in recent years, further accelerated by the need for remote care delivery during the COVID-19 pandemic, and now ranges from telemedicine to serious gaming, wearable devices, AI-supported diagnostics, and clinical decision support systems (CDSSs), among others. Building on the experiences during the pandemic, there is a real potential for the digital transformation of health care to the benefit of patients worldwide. However, the promising developments to date are at risk of stalling due to inherent limitations in the way digital medicine and especially medical artificial intelligence (AI) technologies are being developed and implemented today. [2] Already in 2017, the number of digital medicine technologies on the worldwide market exceeded 318 000, with the mobile application segment growing by over 200 daily. [3] There are widespread expectations that the surge will lead to improvement of health care globally, [4] not least evidenced by the WHO declaration on digital health, [5] and by the rapid growth of private and public investment in this field. [6,7] The advent of digital medicine bears special promise for low-and middleincome countries (LMIC), where applications such as telemedicine and CDSS may enable these countries to "leapfrog" from today's often insufficient healthcare systems into more efficient, accessible, and patient-centric models, [8] similar to what has been seen in Africa's finance sector. [9] The level of improvement possible would correspond to the digital transformation seen in other sectors of society, such as media and retail industries, with the digitalization of processes and service models, beyond the mere digitization of traditional healthcare practices seen so

Digital health interventions are being increasingly incorporated into health care workflows to improve the efficiency of patient care. In turn, sustained patient engagement with digital health interventions can maximize their benefits toward health care outcomes. In this viewpoint, we outline a dynamic patient engagement by using various communication channels and the potential use of omnichannel engagement to integrate these channels. We conceptualize a novel patient care journey where multiple web-based and offline communication channels are integrated through a “digital twin.” The principles of implementing omnichannel engagement for digital health interventions and digital twins are also broadly covered. Omnichannel engagement in digital health interventions implies a flexibility for personalization, which can enhance and sustain patient engagement with digital health interventions, and ultimately, patient quality of care and outcomes. We believe that the novel concept of omnichannel engagement in health care can be greatly beneficial to patients and the system once it is successfully realized to its full potential.

Despite being a convenient clinical substrate for biomonitoring, saliva's widespread utilization has not yet been realized. The non‐Newtonian, heterogenous, and highly viscous nature of saliva complicate the development of automated fluid handling processes that are vital for accurate diagnoses. Furthermore, conventional saliva processing methods are resource and/or time intensive precluding certain testing capabilities, with these challenges aggravated during a pandemic. The conventional approaches may also alter analyte structure, reducing application opportunities in point‐of‐care diagnostics. To overcome these challenges, we introduce the SHEAR saliva collection device that mechanically processes saliva, in a rapid and resource‐efficient way. We demonstrate the device's impact on reducing saliva's viscosity, improving sample's uniformity, and increasing diagnostic performance of a COVID‐19 rapid antigen test. Additionally, a formal user experience study revealed generally positive comments. SHEAR saliva collection device may support realization of the saliva's potential, particularly in large‐scale and/or resource‐limited settings for global and community diagnostics.

Background Digital therapeutics (DTx), a class of software-based clinical interventions, are promising new technologies that can potentially prevent, manage, or treat a spectrum of medical disorders and diseases as well as deliver unprecedented portability for patients and scalability for health care providers. Their adoption and implementation were accelerated by the need for remote care during the COVID-19 pandemic, and awareness about their utility has rapidly grown among providers, payers, and regulators. Despite this, relatively little is known about the capacity of DTx to provide economic value in care. Objective This study aimed to systematically review and summarize the published evidence regarding the cost-effectiveness of clinical-grade mobile app–based DTx and explore the factors affecting such evaluations. Methods A systematic review of economic evaluations of clinical-grade mobile app–based DTx was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Major electronic databases, including PubMed, Cochrane Library, and Web of Science, were searched for eligible studies published from inception to October 28, 2022. Two independent reviewers evaluated the eligibility of all the retrieved articles for inclusion in the review. Methodological quality and risk of bias were assessed for each included study. Results A total of 18 studies were included in this review. Of the 18 studies, 7 (39%) were nonrandomized study–based economic evaluations, 6 (33%) were model-based evaluations, and 5 (28%) were randomized clinical trial–based evaluations. The DTx intervention subject to assessment was found to be cost-effective in 12 (67%) studies, cost saving in 5 (28%) studies, and cost-effective in 1 (6%) study in only 1 of the 3 countries where it was being deployed in the final study. Qualitative deficiencies in methodology and substantial potential for bias, including risks of performance bias and selection bias in participant recruitment, were identified in several included studies. Conclusions This systematic review supports the thesis that DTx interventions offer potential economic benefits. However, DTx economic analyses conducted to date exhibit important methodological shortcomings that must be addressed in future evaluations to reduce the uncertainty surrounding the widespread adoption of DTx interventions. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42022358616; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022358616

Despite human saliva representing a convenient and non-invasive clinical substrate for disease diagnosis and biomonitoring, its widespread utilization has been hampered by technical challenges. The non-Newtonian, heterogenous and highly viscous nature of clinical saliva samples complicate the development of automated fluid handling processes that are vital for accurate diagnoses. Furthermore, conventional saliva processing methods are either resource and/or time intensive precluding certain testing capabilities in low- and middle-income countries, with these challenges aggravated during a pandemic outbreak. The conventional approaches can also potentially alter analyte structure, reducing application opportunities in Point-of-Care diagnostics. To overcome these challenges, we introduce the SHEAR saliva collection device that preprocesses saliva for enhanced interfacing with downstream assays. We demonstrate the device's impact on reducing saliva's viscosity, improving sample uniformity and, increasing diagnostic performance of COVID-19 Rapid Antigen Tests. Importantly, in addition to reporting technical advances and to address downstream implementation factors, we conducted a formal user experience study, which resulted in generally positive comments. Effective implementation of this device could be of support to realize the potential of saliva, particularly in large-scale and/or resource-limited settings for global and community health diagnostics.